Document Detail


Appropriateness of Crohn's disease therapy in gastroenterological rehabilitation.
MedLine Citation:
PMID:  20588039     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The treatment criteria developed by the European Panel on the Appropriateness of Crohn's Disease (CD) Therapy (EPACT) have not been applied to rehabilitation. Thus, we retrospectively evaluated appropriateness of treatments during CD rehabilitation using the EPACT website.
METHODS: We included our 1-year inpatient rehabilitation patients that had been assigned the International Classification of Disease Code for CD. The appropriateness of treatment was assessed in CD categories exhibiting frequent treatment changes. Treatment plans were compared to EPACT recommendations.
RESULTS: Charts of 337 proven CD patients (median age 42 [range 17-65] years, 250 women, median Crohn's Disease Activity Index 140 [range -3 to 427] units) were assigned to EPACT categories. The categories 'steroid-dependent' and 'steroid-refractory' exhibited frequent treatment changes. In these 59 patients, 16 treatments (13 azathioprine, 1 methotrexate, 2 infliximab) were rated as appropriate. One certolizumab treatment was uncertain. 22 treatments with azathioprine were inappropriate (21 due to underdosing), and 93 treatments (30 mesalamine, 59 steroid, 4 budesonide) were not rated. The number of differences between treatment plans and EPACT recommendations decreased from 45 to 25 in both CD categories (p < 0.0001).
CONCLUSIONS: We introduce the EPACT website as a practical advance towards an optimal therapy in rehabilitants with steroid-dependent or -refractory CD.
Authors:
Christoph Reichel; Jürgen Streit; Karin Ott; Steffen Wunsch
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Publication Detail:
Type:  Journal Article     Date:  2010-06-24
Journal Detail:
Title:  Digestion     Volume:  82     ISSN:  1421-9867     ISO Abbreviation:  Digestion     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-27     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150472     Medline TA:  Digestion     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  239-45     Citation Subset:  IM    
Affiliation:
Rehabilitation Centre Bad Brückenau, Clinic Hartwald, German Pension Insurance, Federal Office, Bad Brückenau, Germany. christoph.reichel@web.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Crohn Disease / classification,  rehabilitation*
Female
Germany
Humans
Internet*
Logistic Models
Male
Middle Aged
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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